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This study aims to assess the diagnostic accuracy of targeted ultrasound examination in prenatal diagnosis of hypospadias and to evaluate the predictive values of defined ultrasonographic findings of hypospadias. The cases diagnosed with hypospadias in our fetal medicine center were identified on an electronic database. The ultrasound reports, images and hospital records were reviewed retrospectively. The predictive value of prenatal ultrasound diagnosis and the predictive values of each sonographic finding were assessed according to the postnatal clinical examinations. Thirty-nine cases were diagnosed with hypospadias on ultrasound during the 6 years. Nine fetuses with missing postnatal examination records were excluded. Twentytwo of the remaining fetuses had their prenatal diagnosis of hypospadias confirmed in postnatal examinations, indicating a 73.3 % positive predictive value. Normal external genitalia was detected in postnatal examinations of three fetuses. Five fetuses were diagnosed with other external genital abnormalities, including micropenis (n=2), clitoromegaly (n=2), and buried penis with bifid scrotum (n=1) in postnatal examinations. The positive predictive value of prenatal ultrasound for any external genital abnormality was 90 %. Although the positive predictive value of ultrasound for genital anomalies is satisfying, it is slightly lower for the specific diagnosis of hypospadias. This reflects overlapping ultrasound findings of different external genitalia anomalies. Standardized, systematic evaluation of the internal and external genital organs, karyotyping and genetic sex determination are essential to achieve a precise prenatal diagnosis of hypospadias. [ABSTRACT FROM AUTHOR]

Background: The major influencing factors for complications during hypospadias repair are the original location of the meatus, previous urethral surgery, surgical technique, and surgeon's experience. While the effect of the technique of regional analgesia on complication rates has been considered in some studies, this issue remains controversial. Aims: To determine the effect of caudal block and penile block on complication rates of hypospadias repair in patients with subcoronal hypospadias. Study Design: Retrospective cross-sectional study. Methods: Data of children who underwent hypospadias repair between 2011 and 2019 in our clinic (n = 770) were reviewed retrospectively. Only patients with subcoronal hypospadias and who underwent tubularized incised plate urethroplasty, performed by the same two experienced surgeons (n = 279), were included in the study. The exclusion criteria were incomplete data and follow-up time shorter than 12 months. Data of 279 patients were analyzed. Patients were divided into two groups according to the analgesia type: caudal block (n = 95) and penile block (n = 184), and complication rates were compared between these groups. Results: The median age was 36 months in the caudal block group and 30 months in the penile block group (P = 0.390). The median follow-up times were 54 and 42.7 months in the caudal and penile block groups, respectively. Total complication rates did not differ significantly between the groups and were determined as 10.5% and 12.5% in the caudal and penile groups, respectively. Urethrocutaneous fistula rates were observed as 2.1% and 4.3% (p=0.50). None of the patients had penile chordee and no penile plication was performed in the whole group. Conclusion: This study shows that there is no increase in post-repair complications in patients with subcoronal hypospadias who underwent caudal block. [ABSTRACT FROM AUTHOR]

Objective: Hypospadias is a congenital anomaly of the male urethra that is becoming increasingly prevalent. In this paper, we share the results of our series of 45 distal hypospadias cases treated with tubularized incised plate urethroplasty (TIPU) at a single center in Şanlıurfa, Turkiye. Materials and Methods: Hypospadias repairs were made by two urologists who had completed their urology residencies at the same clinic in a state hospital. The TIPU technique was used for all 45 patients. To prevent bladder contractions and reduce anal itching during hospitalization, the patients were administered low-dose oxybutynin and 2 mg/mL hydroxyzine hydrochloride; they were also followed up postoperatively for a mean duration of 9.3 (6-12) months. Results: The average age of the patients was 9.5±0.5 (2-24) years. Ten patients had been circumcised previously, preoperative skin chordee was observed in 35, and none experienced preoperative complications. Postoperative catheterization lasted seven days. Postoperatively, one patient developed a fistula and two developed meatal strictures. No other complications were observed in the other patients. Conclusion: Hypospadias is an anomaly frequently seen in pediatric urology practice and requires considerable attention and experience. TIPU is an ideal technique for correcting hypospadias, especially distal hypospadias, due to its low complication rate and favorable cosmetic results. Although hypospadias surgery requires experience, it can be done quite easily in peripheral hospitals by surgeons who have trained in clinics experienced in this field, provided that they follow the rules pertaining to surgery. [ABSTRACT FROM AUTHOR]

Objective: Aim of the study is to determine the hemostatic techniques among pediatric urologists in Turkey. Material and methods: Questionnaire forms were sent to 459 pediatric urologist by e-mail. Results: Ninety eight of 459 participants answered the questionnaire forms. Eighty-one (84.4%) of the participants were using tourniquet. The participants who didn't use tourniquet stated their justifications as follows: lack of need (n=10: 66.7%), development of edema, ischemia, delay of wound-graft healing and fistula risk (n=5: 33.3%). The indications of tourniquet use were stated as follows: penile (91.4%: n=74), distal (72.8%: n=59), penoscrotal (55.6%: n=45) hypospadias; fistula repair (33.3%: n=27), cripple hypospadias (33.3%: n=27), repair with flaps (30.9%: n=25), repair with grafts (27.2%: n=22), and isolated penile curvature (21%: n=17). Most commonly used tourniquet material (49.9%) was latex glove. Erection test was applied by 43.8% of participants. Scalp vein set was the most commonly (54.8%) used injector during erection test. Only 9.4% of participants were using adrenaline. Adrenaline dosages used at 1/100.000 dilution by 55.6%, lidocaine with 1/100.000 adrenaline by 44.4% of participants. Conclusion: Beside a few experimental ones there is a paucity of studies that can serve as a guideline for using these techniques in the literature. There is a necessity of realizing prospective, randomized studies with long-term follow up to evidence that postoperative complications could develop secondary to hemostatic techniques and also to facilitate safe use of these techniques. [ABSTRACT FROM AUTHOR]

Objective: Disorders of sex development (DSD) is a nomenclature intended to defeat the discomfort of families and patients and has found worldwide usage. The aim of this study was to address the perception and usage of terminology among the parents of DSD patients in a tertiary center in western Turkey. Methods: The records of the DSD council (multidisciplinary team where each patient with DSD is discussed) between years 2008-2015 were reviewed retrospectively. Data including details of the management process, patient characteristics and follow-up details were noted. Then inquiries reflecting parental perception about terminology were implemented during clinical visits. Results: In total, 121 patients were evaluated in monthly meetings of the DSD council and 79 inquiries were completed. Fifty-one percent of the families admitted knowing the terms DSD, ambiguous genitalia, "dubious genitals" and intersex. However, only 2% preferred using DSD, 6% intersex and 14% ambiguous genitalia. Fifty-two percent of the parents used a disease name in Latin (mostly hypospadias) addressing the disorder. The offspring of 69% of the parents who were familiar with the name "dubious genitals" were diagnosed in the neonatal period. The preferred terminology used by parents was strongly associated with the terminology used most commonly in the medical speciality their child most often attended. Conclusion: Each country has its own social norms. We suggest therefore that local committees including medical professionals, patients and families should be employed to develop proper terminology. [ABSTRACT FROM AUTHOR]

Background/aim: Nowadays surgical intervention is possible in smaller phalluses and younger children with hypospadias disease. Different hormone treatments with different doses, modalities, indications, and treatment times come along with some disputes. The aim of this study is to evaluate the management approaches in hypospadias surgery of surgeons in regards to hormone preparations. Materials and methods: Questionnaires were sent via e-mail to 110 actively working pediatric surgeons and urologists. The answers of 99 surgeons were evaluated (90%). Two surgeons declared that they did not perform hypospadias surgery. Results: When testosterone usage in penile surgery was questioned, 44.4% of participants (n = 44) answered positively. Small-short penis glans, narrow urethral plate, chordee, disorders of sexual development, buccal mucosa-graft operations, slight tissue, and defective ventral skin were the indications for usage. Forty of forty-four surgeons stated usage in proximal hypospadias, 18 of them in penile hypospadias, and 15 of them in distal hypospadias. The most common form was dihydrotestosterone (62%). According to the respondents, fistulas (83%), infections (78%), and wound dehiscence (77%) were reduced. Fifty-six percent of the surgeons stated that bleeding was increased and 39% stated easier dissection. Conclusion: As a result of this questionnaire we can understand that there is no standard usage of testosterone in Turkey. Optimal points of usage can be introduced by increasing prospective randomized trials and education programs can ensure similar effective usage. [ABSTRACT FROM AUTHOR]

Objective There are limited reports studying on congenital cutaneous anomalies in newborns, particularly in Turkey. Some of congenital cutaneous anomalies serve as an important clue for accompanying syndromes or other medical conditions. This study aimed to determine the prevalence of congenital cutaneous anomalies in newborns and to discuss their clinical significance with a brief review of literature. Study Design A total of 1,000 newborns were examined by a dermatologist in a hospital-based, cross-sectional, prospective study between October 2011 and April 2012. Results We observed 11 different congenital cutaneous anomalies in 48 newborns of 1,000 (4.8%). The most commonly seen anomalies were sacral dimple, accessory nipple, acrochordon, hypospadias, open spinal dysraphism, and accessory tragus. None of the newborns with cutaneous anomalies had any association. Conclusions Although congenital cutaneous anomalies are rare in newborns, clinicians should be aware of them as they may be in association with syndromes and other medical conditions. It is also important to give appropriately provided information to avoid parents concerns. [ABSTRACT FROM AUTHOR]

Urethrocutaneous fistula (UCF) is one of the most common complications occurring after hypospadias repair. Despite the surgical advancement in hypospadias, multiple failed fistula closures are commonly referred to paediatric urologists. Although several techniques have been described to interpose a waterproof layer between urethral and skin closures, occurrence of urethrocutaneous fistula cannot be eliminated completely. In addition to several local tissue grafts, autologous and homologous fibrin sealants are used to prevent UCF. Platelet rich fibrin (PRF) is known as an autologous source of growth factors obtained from the sera of the patient. PRF supports collagen synthesis and tissue repair and accelerates wound healing. We aimed to present our initial experience about the use of autologous PRF in a 3-year-old boy with a UCF after hypospadias repair. [ABSTRACT FROM AUTHOR]

Background: The aim of the present prospective study was to determine the incidence of hypospadias in newborns in one of the busiest teaching hospitals of Istanbul, and to investigate the risk factors. Methods: All live-born boys delivered between September 2007 and December 2008 were screened for hypospadias. A questionnaire was given to the parents of the hypospadias and control subjects for investigation. Results: Out of 1750 boys examined, 34 had hypospadias, that is, the frequency was 19.4 per 1000 male live-births and 93.7 per 10 000 total live-born deliveries. The incidence of additional coexistent anomalies was 29.4%, predominantly urogenital (17.6%), the majority of which were cryptorchidism (14.7%). Twelve (35.3%) of the 34 hypospadiac boys had a second family member with a genital anomaly, nine (26.5%) of whom had hypospadias, three (8.8%) being the fathers. Mean birthweight, length and head circumference were significantly lower in the hypospadiac infants than the control group ( P= 0.003, P= 0.025, P= 0.002). Although parity, parental consanguinity, hypospadias in family members, and low birthweight also varied significantly among the groups, logistic regression analysis indicated that maternal age, prematurity, coexistence of cryptorchidism and presence of genital anomaly among family members were independent risk factors for hypospadias ( P= 0.016, P= 0.0001, P= 0.041, P= 0.0001, respectively). Conclusions: Genetic predisposition and placental insufficiency in early gestation might play a role in the etiology of hypospadias. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the frequency of external genital organ diseases and the congenital abnormalities in healthy adolescent boys living in Turkey. Materials and methods: Overall 6,400 male students aged 13-15 years from 7 different geographic regions of Turkey who were applied to military high school were examined for possible external genital organ diseases and congenital anomalies. Physical examination was performed by two urologists at room temperature and standing position. Results: Mean age was 14.1 years. Distribution of students to different geographic regions was as follows; Marmara 13.4%, Aegean 13.9%, Mediterranean 11.7%, Middle Anatolian 28%, Black Sea 14.7%, East Anatolian 6.9%, and Southeast Anatolian 2.7%. The number of children with external genital organ diseases were as follows: 23 hypospadias (0.36%), 207 varicoceles (3.2%), 53 undescended testes (0.83%), 11 hydroceles (0.17%), and 16 buried penises (0.25%). Conclusion: This is the first study performed in an adolescent population representing our country which determined the frequency of external genital organ anomalies in healthy adolescent boys living in 7 different geographic regions in Turkey. [ABSTRACT FROM AUTHOR]

The complication rates are still 1-90% both in proximal and distal hypospadias regardless of the surgeon's experience and the usage of most developed techniques. The literature survey revealed few complications of glans penis including meatal stenosis, prolapsus and retraction. Despite our literature survey, we could not find any article concerning the permanent scar tissue at the dorsal part of glans following hypospadias surgeries. A new complication can be added to these, concerning glans which is the formation of postoperative scar tissue as a reaction to suture material used in traction, stent anchoring or both. The aim of this paper is to demonstrate four cases which had glanular scar due to traction suture following the surgical procedures for hypospadias repair. [ABSTRACT FROM AUTHOR]

The article features the highlights of the 1st World Congress on Hypospadias and Intersex Disorders which was recently held in Istanbul, Turkey, from November 17-19, 2005. The conference was held under the auspices of the International Society on Hypospadias and Intersex Disorders. The event includes two big round table conferences on intersex disorders and on hypospadias. Issues discussed included problems in intersex.

The Wiedemann-Rautenstrauch or neonatal progeroid syndrome: report of a patient with hypospadias: Wiedemann-Rautenstrauch syndrome is known as a neonatal progeroid syndrome, with only few published case reports. The syndrome is characterized by progeroid appearance (triangular old-looking face with relatively large skull, prominent veins especially of the scalp, sparse scalp hair, and large anterior fontanelle), decreased subcutaneous fat (giving the clinical appearance of prominent veins and muscles), hypotrichosis, macrocephaly, and natal teeth. We report a new additional patient with a new feature of the hypospadias, not previously described, to our knowledge.